Intraoperative monitoring of cranial nerves in skull base surgery. Medical search. Frequent questions

EEG electroencephalography is used for monitoring of cerebral function in neurovascular cases (cerebral aneurysms, carotid endarterectomy) and for defining tumor margins in epilepsy surgery and some cerebral tumors. (wikipedia.org)
Many factors can increase the incidence of iatro genic Facial Nerve injury, including congenital anomalies, revision surgery, tumors, and severe inflammatory processes. (evokedpotential.com)
After which he returned to Vancouver and has been a practicing neurosurgeon, specializing in skull base tumors. (ubc.ca)
He is an acknowledged expert in the field of Skull Base surgery, having performed over 600 pituitary tumors and 600 acoustic neuroma surgeries. (ubc.ca)
He has authored many scientific papers and chapters on monitoring and Skull Base tumors. (ubc.ca)
A large part of that was because we had a very dynamic surgical team and lots of people that came to us for intra-cranial problems, skull-base tumors and other issues. (audiologyonline.com)
Removal of tumors and treatment of vascular lesions that occur at the base of the skull can be some of the most technically challenging surgeries. (lsuhs.edu)
This article offers an overview of tumors that develop at the skull base and their surgical management. (medscape.com)
Tumors and surgical approaches are classified based on the involved area. (medscape.com)
These tumors often arise from the paranasal sinuses but may develop in the frontal bone (arising from the area of the frontal sinus), cranial vault, mastoid sinus, or mandible. (medscape.com)
Osteomas have been associated with Gardner syndrome, an autosomal-dominant variant of familial adenomatous polyposis, which consists of multiple cranial osteomas, colonic polyposis, and soft-tissue tumors. (medscape.com)
Hemangiomas of the skull are benign vascular bone tumors composed of cavernous or capillary vascular channels. (medscape.com)
They make up approximately 7% of skull tumors. (medscape.com)
Dermoid and epidermoid tumors are benign lesions of the skull that develop in the cranial vault, paranasal sinuses, orbit, and petrous bone. (medscape.com)
These tumors usually arise in the midline, in the diploe of the bone, where they expand both the inner and outer tables of the skull. (medscape.com)
The functions of the lower cranial nerves are formally established for large and giant tumors with inferior extension. (neurosurgicalatlas.com)
Despite extension of the large and giant tumors through the jugular foramen, they are microsurgically dissected off of the lower cranial nerves without significant risk. (neurosurgicalatlas.com)
Thanks to neuromonitoring, the department's surgeons can remove tumors located near important regions in the brain or cranial nerves. (bookinghealth.com)
Materials and methods We present an evidence-based review of the perioperative process involved in endoscopic embolization of skull base tumors. (bmj.com)
The primary skull base tumors that most commonly benefit include meningioma, juvenile angiofibroma, and paraganglioma. (bmj.com)
Rather, the tumors compress the nerves that promote facial sensation and facial muscle movement. (facialparalysisinstitute.com)
NF2 is caused by a malfunctioning tumor suppressor gene on chromosome 22, leading to the growth of benign (noncancerous) tumors on the nerves that control balance in the inner ear. (facialparalysisinstitute.com)
This book aims to give the state-of-the-art of intraoperative brain function mapping for resection of brain tumors in awake conditions, and to become a reference for acquiring the fundamental expertise necessary to select the right intraoperative task at the right time of the surgery. (neurochirurgie-lariboisiere.com)
In the transsphenoidal approach, tumors invading the CS through its medial wall are approached inferomedially following the direction of tumor growth, which spares the cranial nerves. (surgicalneurologyint.com)
These efforts are centered on improving surgery for patients with epilepsy and brain tumors, particularly those whose pathology is intimately involved with critical brain regions. (dana-farber.org)
The key attention is paid to the treatment of cerebrovascular diseases, diseases of the spine and spinal cord, brain and skull base tumors, peripheral nerve lesions, cerebrospinal fluid circulation disorders, as well as pain therapy (functional neurosurgery). (bookinghealth.com)
Dr. Lim's clinical interests include the treatment of benign and malignant brain tumors, with special interest in gliomas, meningiomas, metastatic tumors, and skull base tumors. (stanfordhealthcare.org)

[ 9 ] In neurofibromatosis 2 (NF2), the eighth cranial nerve is affected, and the classic finding is a bilateral vestibular schwannoma. (medscape.com)
An acoustic neuroma (vestibular schwannoma) arises from your eighth cranial nerve, which actually is composed of two nerves: (1) the vestibular nerve that carries messages from your inner ear to your brainstem to help regulate your body balance and eye movements, and (2) the cochlear nerve that is involved with your hearing. (welldonesite.com)
Schwann cells form a sheath around your eighth cranial nerve. (welldonesite.com)
An acoustic neuroma occurs on the eighth cranial nerve. (facialparalysisinstitute.com)
The eighth cranial nerve (CN VIII) or vestibulocochlear nerve is composed of 2 different sets of fibers: (1) the cochlear nerve and (2) the vestibular nerve. (medscape.com)

A conservative approach is prudent if the surgeon who performs an acoustic neuroma feels that the nerve was saved during the operation. (facialparalysisinstitute.com)
Tumor size, surgeon experience, and approach for surgery are important factors to determine the success of an acoustic neuroma procedure. (facialparalysisinstitute.com)

This provides some degree of confidence to the surgeon that these cranial nerves are not being disrupted during tumor exposure and removal. (entokey.com)
The image below depicts a CT scan revealing a skull base tumor. (medscape.com)
If the tumor grows large enough, it can put pressure on other nearby nerves, blood vessels and brain structures. (welldonesite.com)
Observation If the tumor is not big or growing rapidly, observing the tumor by monitoring your symptoms and checking scans may be considered or recommended. (welldonesite.com)
Several different approaches or trajectories can be chosen based upon the size and location of the tumor. (welldonesite.com)
You will need to stay in the hospital for a few days after surgery, with the length of stay usually depending on the size of your tumor and the extent of surgery. (welldonesite.com)
such vessels should be carefully protected if ultrasonic aspirator devices are used during surgery for tumor decompression. (neurosurgicalatlas.com)
The tumor can be imagined during surgery by staining with a fluorescent drug, which the patient takes prior to the procedure. (bookinghealth.com)
The risk of lower cranial nerve dysfunction is correlated with the size of the tumor and may present with postoperative dysphasia, hoarseness, or aspiration. (neupsykey.com)
For instance, the vertical facial nerve may be displaced more laterally than usual due to lateral tumor extension. (neupsykey.com)
Additionally, it provides the interventionalist with the opportunity to become familiarized with the vasa nervorum and arteries supplying cranial nerves, as well as the tributaries supplying the tumor, thereby informing selection of an appropriate embolic agent. (bmj.com)
While effective intervention can yield improved perioperative visualization with reduced tumor size and resultant blood loss, important risks for consideration include cranial nerve injury, tissue necrosis, access vessel injury, and death from inadvertent non-target embolization. (bmj.com)

Endoscopic surgery of the cranial base is frequently utilized for pathologies such as pituitary adenoma, craniopharyngioma, chordoma, and chondrosarcoma. (entokey.com)
Here we present discussions of neuromonitoring techniques most commonly used in endoscopic endonasal skull base surgery. (entokey.com)
During endoscopic skull base surgery, EMG can be used for monitoring of any cranial nerve with motor function including cranial nerves III-VII and X-XII. (entokey.com)
Because of their relative frequency of use in endoscopic skull base surgery, EMG monitoring of the extraocular muscles will be a particular focus of this chapter. (entokey.com)
You'll find detailed, superbly illustrated guidance on all of the endoscopic, microscopic, laser, surgically-implantable, radio-surgical, neurophysiological monitoring, and MR- and CT-imaging technological advances that now define contemporary operative OHNS - all in one comprehensive, two-volume reference. (pickpdfs.com)
Offers expanded coverage of endoscopic techniques for cranial base surgery, plus information on the latest endoscopic cancer techniques including robotic surgery, minimally invasive thyroid surgery, and new techniques for the treatment of obstructive sleep apnea including implantable nerve stimulators. (pickpdfs.com)
We offer the most advanced techniques and technologies in surgical approaches such as cranial nerve monitoring, endoscopic visualization, intraoperative imaging and navigation, neuroendovascular techniques, intraoperative and stereotactic radiation that dramatically improve patient outcomes and quality of life. (lsuhs.edu)
Endoscopic endonasal transsphenoidal surgery (EES) is the gold standard for pituitary adenoma (PA) resection. (surgicalneurologyint.com)
5 ] Approximately 2% of cases with sellar lesions present no SS pneumatization, which increases the difficulty level of endoscopic endonasal transsphenoidal surgery (EES). (surgicalneurologyint.com)
This retrospective monocentric study included 17 patients who underwent endoscopic sinus surgery evaluated by paranasal computed tomography and magnetic resonance imaging. (actaitalica.it)
This single-centre retrospective study included 17 patients affected by IFRS who underwent endoscopic sinus surgery (ESS) at the ENT Department in San Luigi Gonzaga Hospital, Turin, Italy between January 2016 and January 2020. (actaitalica.it)

The use of intraoperative monitoring improves postoperative facial nerve (Facial Nerve) function and is an indispensable tool for facilitating surgery involving the Facial Nerve. (evokedpotential.com)
It has been found that rectal surgery still leads to high rates of postoperative urinary, fecal, or sexual dysfunction, which is why nerve-sparing surgery has gained increasing importance. (bvsalud.org)
It has high specificity and negative predictive value regarding postoperative cranial nerve deficits. (entokey.com)
Recognition of the extent of pneumatization of the temporal bones and appropriate preparation for intraoperative repair can minimize the risk of a postoperative cerebrospinal fluid (CSF) leak. (neurosurgicalatlas.com)
Strategies to ameliorate craniotomy pain demand interventions during all phases of patient care: preoperative, intraoperative, and postoperative interventions. (surgicalneurologyint.com)
ERAS protocols divide the key components of perioperative care according to phase of care: preoperative, intraoperative, and postoperative interventions. (surgicalneurologyint.com)
The accuracy level of surgery fell to 0.93 mm of total median difference for the corresponding zygoma points of preoperative simulations and postoperative zygoma. (biomedcentral.com)

Contains state-of-the-art guidance on the ear/temporal bone/skull base, including fully- and semi-implantable auditory implants, vestibular implants, imaging advances, radiosurgical treatment of posterior fossa and skull base neoplasms, intraoperative monitoring of cranial nerve and CNS function, minimally-invasive surgical approaches to the entire skull base, vertigo and postural disequilibrium, and much more. (pickpdfs.com)
A 20-year-old female with HCS and progressive symptomatic BI, initially managed with posterior fossa decompression and occipital to cervical fusion, subsequently required cranial vault expansion due to symptomatic shifting of her cranium secondary to POCS. (thejns.org)
Microvascular Decompression (MVD) offers effective, long-term symptom relief for patients with pathologies related to neurovascular conflicts of cranial nerves in the posterior fossa. (heraldopenaccess.us)

Intraoperative neurophysiological monitoring (IONM) or intraoperative neuromonitoring is the use of electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and evoked potentials to monitor the functional integrity of certain neural structures (e.g., nerves, spinal cord and parts of the brain) during surgery. (wikipedia.org)
A Proposal for Intraoperative Management Based on Neurophysiological Data Analysis in a Series of Ninety-Two Patients. (neurologicsbcn.com)
CONCLUSION: We demonstrate the evolving trends in neurophysiological monitoring over the past 25 yr from a single, academic neurocritical care unit. (neurosurgery-blog.com)

Motor evoked potentials have also been used in surgery for thoracic aortic aneurysm. (wikipedia.org)
More recently, transcranial electric motor evoked potentials (TCeMEP) have also been used for spinal cord monitoring. (wikipedia.org)
He has an interest in intraoperative monitoring techniques and has introduced the use of motor evoked potentials for monitoring cranial nerves during Skull Base surgery. (ubc.ca)

Every trainee receives a focused experience in each of the main subspecialties, working in close conjunction with an expert senior attending physician who is a leader focused in such areas as neurovascular, functional neurosurgery, pediatric neurosurgery, skull base neurosurgery, spine, and epilepsy. (lsuhs.edu)
Our Pediatric Neurosurgery service offers comprehensive care and a multi-disciplinary approach for the full range of brain, spine, peripheral nerve, and craniofacial disorders in children and adolescents. (lsuhs.edu)
The Section of Neurosurgery is based at the Health Sciences Centre and Winnipeg Children's Hospital. (manitobaneurosurgery.com)
This involves the use of advanced technological devices that have become the standard of care when neurosurgery and spinal surgery are necessary. (princetonneurologicalsurgery.com)
Neurosurgery or neurological surgery , known in common parlance as brain surgery , is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain , spinal cord and peripheral nervous system . (wikipedia.org)
Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.) with Residency in Neurosurgery or Fellowship of the Royal College of Surgeons (F.R.C.S. (wikipedia.org)
These fellowships include pediatric neurosurgery , trauma/neurocritical care, functional and stereotactic surgery, surgical neuro- oncology , radiosurgery, neurovascular surgery, skull-base surgery, peripheral nerve and complex spinal surgery. (wikipedia.org)
Most of the medical colleges and teaching hospitals in the country provide post general surgery 3 years neurosurgery course. (wikipedia.org)
AVALA (Covington, La.). Physician-owned AVALA Spine & Neurosurgery offers comprehensive spine-related condition care including clinic visits, surgery, inpatient care, physical therapy and follow-up care. (beckershospitalreview.com)
The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the brain, spine, spinal cord and nerves in adults and children. (bookinghealth.com)

Petroclival meningiomas represent the most complex lesions in skull base surgery, being closely related to critical neurovascular structures. (neurochirurgie-lariboisiere.com)
The SS, a highly variable anatomic structure, is located in the center of the cranial base, surrounded by numerous neurovascular structures. (surgicalneurologyint.com)

Purpose Neuroendovascular procedures are performed in skull base neoplasias with the objective of achieving preoperative embolization to increase the safety of surgical procedures by limiting intraoperative hemorrhage, reduce the need for blood transfusion, increase visibility in the surgical field, and shortening hospitalization length. (bmj.com)
Additional parameters including circumstances in which temporary or liquid embolic agents are more amendable, preoperative imaging features, procedural details of angioembolization, and subsequent follow up monitoring are also discussed. (bmj.com)
100 ] Preoperative interventions aim at optimizing the patient for surgery, including patient education, risk assessment, and medication. (surgicalneurologyint.com)
Surgical Simulation -- Developing immersive environment for simulation of ear and skull base surgery for training, technique assessment, and preoperative planning. (stanford.edu)

2000 ). The lack of an epineural covering in the intracranial segment of the nerve is an additional factor that makes it more vulnerable to injury where even mild stretching may produce significant damage to the nerve. (evokedpotential.com)
Solitary intracranial plasmacytoma of the skull base carries a dissemination rate of up to 100%, which is considerably higher than the rate associated with intracranial plasmacytoma of the dura or convexities. (medscape.com)
Intracranial pressure (ICP) is a clinically important variable after severe traumatic brain injury (TBI) and has been monitored, along with clinical outcome, for over 25 yr in Addenbrooke's hospital, Cambridge, United Kingdom. (neurosurgery-blog.com)
OBJECTIVE: To describe the changes in intracranial monitoring variables over the past 25 yr. (neurosurgery-blog.com)
The VIIth and VIIIth nerves are encased in glial tissue throughout their intracranial course. (medscape.com)

However, the use and outcome of Facial Nerve monitoring in specific clinical disorders is beyond the scope of this chapter. (evokedpotential.com)
Our endovascular neurosurgeons manage all aspects of stroke and cerebrovascular disorders as well as the coordination of subsequent therapeutic strategies including surgery, interventional neuroradiology, stereotactic radiosurgery and rehabilitation. (lsuhs.edu)
Skull base disorders can impact many body functions in addition to the nervous system. (lsuhs.edu)
Although skull base surgical approaches are also used for vascular disease, congenital anomalies, and some nonneoplastic bony disorders, this section focuses on neoplastic disease. (medscape.com)
Surgery of the Brainstem, by internationally renowned neurosurgeons Robert F. Spetzler, M. Yashar S. Kalani, and Michael T. Lawton, along with an impressive cadre of global experts, is a comprehensive guide to managing disorders of the brainstem, thalamic region, and basal ganglia. (ebooksmedicine.net)

Monitoring can be established to prevent injury to the brain, spinal cord, cranial nerves and peripheral nerves throughout the body while undergoing surgery. (princetonneurologicalsurgery.com)

Schwannomas are slow-growing, benign, encapsulated neoplasms that arise from the nerve sheath and consist of Schwann cells in a collagenous matrix. (medscape.com)
Conclusion Neurointerventional procedures play a pivotal role in the management of skull base neoplasms. (bmj.com)

When certain delicate procedures are being performed on the spine or spinal cord, brain or an area rich with nerves, IOM is very valuable. (princetonneurologicalsurgery.com)
The program's team is made up of spine and neurosurgeons, pain management specialists, physical therapists, and clinical teams which have invested in advanced MRI and CT diagnosis, minimally invasive spine surgery and robotic-assisted procedures such as the Globus ExcelsiusGPS robot for spine surgery and a Globus Medical Excelsius3D for intraoperative imaging. (beckershospitalreview.com)
In partnership with Twin Cities Spine Center, it has one of the nation's longest standing spine surgery fellowship programs. (beckershospitalreview.com)

For more complex surgical cases, where auditory brainstem response (ABR) may be monitored as well as multiple cranial motor nerves, a multichannel system with averaging capabilities should be used. (evokedpotential.com)

The electrodes are used to monitor the recurrent laryngeal and vagus nerves in head and neck surgical procedures, including thyroid and parathyroid surgeries, cranial nerve monitoring, carotid endarterectomies, and skull-base surgeries. (neurosign.com)
however, extensive cholesteatomas involving the internal auditory canal and petrous apex, lower cranial nerve neuromas, and carotid artery aneurysms may be approached in a similar manner. (neupsykey.com)

Before the advent of magnetic resonance imaging (MRI), imaging of the cranial nerves was difficult, and mass lesions arising from these nerves was often indirectly detected only by looking at bony changes in the skull base foramen or by using invasive techniques such as cisternography and angiography. (medscape.com)
[ 1 ] Artifact from the skull base limits the soft-tissue resolution of CT scans, particularly in small lesions. (medscape.com)
Intraoperative neurophysiologic monitoring of cranial nerves enables the surgeon to confidently operate on offending lesions with continuous feedback on the integrity of cranial nerves. (entokey.com)
They are among the most common benign skull lesions in children. (medscape.com)
[ 3 ] Paragangliomas are locally invasive, and approximately 40% expand into the posterior cranial fossa, where they are identified as lesions of the cerebellopontine angle. (medscape.com)
Intraarterial (IA) indocyanine green (ICG) angiography is an intraoperative imaging technique offering special and temporal characterization of vascular lesions with very fast dye clearance. (thejns.org)
Sensorineural hearing loss is caused by lesions of either the inner ear (sensory) or the auditory (8th) nerve (neural). (msdmanuals.com)

You have 12 paired, cranial nerves (one for your left and right side) that arise directly from your brain or brainstem. (welldonesite.com)
It is noncancerous and grows on a tiny nerve that is located near facial nerves between the inner ear and brainstem. (facialparalysisinstitute.com)
[ 1 , 2 ] The length of the vestibulocochlear nerve, from the glial-Schwann junction to the brainstem, is 10-13 mm in the human male and 7-10 mm in females. (medscape.com)

To improve functional outcomes, techniques to preserve pelvic autonomic nerves by identifying anatomic landmarks and implementing intraoperative neuromonitoring methods have been investigated. (bvsalud.org)
Covers everything from why a procedure should be performed to the latest surgical techniques to post-operative management and outcomes - from experts in otolaryngology, plastic surgery, oral and maxillofacial surgery, neurological surgery, and ophthalmology. (pickpdfs.com)
Predictive Effect of Bone Conduction Pattern on Hearing Outcomes of Stapes Surgery. (uc.edu)
Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. (surgicalneurologyint.com)
The purpose of this study was to evaluate outcomes and complications associated with infant ear molding at a single institution.We conducted a retrospective chart review of all infants who underwent ear molding using the EarWell Infant Ear Correction System with pediatric plastic surgery from October 2010 to March 2021. (stanford.edu)
POCSs in patients with BI complicate traditional surgical approaches, necessitating more invasive techniques to secure all mobile cranial parts for optimal outcomes. (thejns.org)
Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery. (e-jyms.org)

vestibular schwannomas are the most common cranial nerve (CN) schwannomas, followed by trigeminal and facial schwannomas and then glossopharyngeal, vagus, and spinal accessory nerve schwannomas. (medscape.com)
This chapter will consider the technical aspects of Facial Nerve monitoring. (evokedpotential.com)
The different techniques used to monitor the Facial Nerve are discussed with emphasis on how to conduct the technique and solve common problems to ensure successful monitoring. (evokedpotential.com)
Several intraoperative events can pose an increased risk of injury to the Facial Nerve. (evokedpotential.com)
These factors may distort normal anatomical relations, or cause the Facial Nerve to be thinned and attenuated thus making dissection around the nerve a more difficult task ( May et al. (evokedpotential.com)
Whatever the mechanism, iatrogenic injury can produce variable effects ranging from mild transient to severe irreversible damage to the Facial Nerve. (evokedpotential.com)
A mild transient injury may result from interruption of the myelin sheath covering the nerve leading to delayed latency of the recorded compound muscle action potential (CMAP) recorded from the facial muscles. (evokedpotential.com)
Therefore, when assessing the integrity of the Facial Nerve after an injurious event, it is essential to ensure that the stimulator is placed proximal to the site of injury. (evokedpotential.com)
The instrumentation requirements for Facial Nerve monitoring are basically similar to those used for electrodiagnostic purposes. (evokedpotential.com)
Multiple channel systems are recommended as they allow monitoring of multiple divisions of the Facial Nerve independently, as well as other cranial motor nerves if needed. (evokedpotential.com)
Even in cases where only the Facial Nerve is at risk, the extra channels can be hooked to the contralateral facial muscles to provide a valuable control for nonspecific increases in EMG activity due to light anesthesia or other nonsurgical factors. (evokedpotential.com)
EMG was first used intraoperatively in the 1960s for the monitoring of facial nerve function during exploratory parotid surgery. (entokey.com)
For transclival approaches to prepontine or cerebellopontine angle pathologies, the facial nerve, vagal nerve, accessory nerve, and hypoglossal nerve may additionally be monitored. (entokey.com)
The functional status of the facial nerve is monitored by recording EMG of the orbicularis oris and orbicularis oculi muscles. (entokey.com)
It is a combination craniotemporal-cervical approach and requires anterior transposition of the facial nerve. (neupsykey.com)
however, grade 1 facial nerve function can be achieved after facial nerve transposition. (neupsykey.com)
Facial nerve and lower cranial nerve monitoring is performed on all cases. (neupsykey.com)
The treatment approach to facial paralysis in this patient population depends on the intraoperative surgical findings. (facialparalysisinstitute.com)
HFS involves compression at the seventh cranial nerve and is characterized by involuntary, irregular, unilateral twitching of facial muscles [2]. (heraldopenaccess.us)
They are also joined by the facial nerve in the IAC. (medscape.com)
Embryologically, the vestibulocochlear (acousticovestibular) ganglion initially develops fused with the VIIth nerve (facial) ganglion. (medscape.com)
However, supporting Schwann and satellite cells, as in all cranial ganglia, are entirely of neural crest origin, apparently arising from the ganglion of the facial nerve (see the image below). (medscape.com)
Recent advances in computer-assisted surgery allow three-dimensional (3D) orthognathic analysis, surgical simulation, and 3D printing of surgical guides using computed tomography (CT) images during the treatment of deformity or facial asymmetry [ 1 ]. (biomedcentral.com)
CAD/CAM-based surgical guides for malarplasty allow the shape, height, and curve of the osteotomy line to be made accurately and adjusted easily with consideration for changes in facial soft tissue. (biomedcentral.com)
It can benefit both experienced and junior surgeons regardless of the type of facial bony plastic surgery. (biomedcentral.com)

Evaluation of multimodal intraoperative neurophysiologic monitoring during supratentorial aneurysm surgery: a comparative study. (neurologicsbcn.com)

Optic nerve decompression surgery (also known as optic nerve sheath decompression surgery) involves cutting slits or a window in the optic nerve sheath to allow cerebrospinal fluid to escape, thereby reducing the pressure around the optic nerve. (aetna.com)
Initial results of uncontrolled studies suggested that optic nerve sheath decompression was a promising treatment of progressive visual loss in patients with NAION. (aetna.com)
To resolve the controversy over the effectiveness of optic nerve decompression for NAION, the National Eye Institute sponsored the Ischemic Optic Neuropathy Decompression Trial, a multicenter, randomized controlled clinical trial of optic nerve decompression surgery for patients with NAION. (aetna.com)
The investigators concluded that optic nerve decompression surgery is not an effective treatment for NAION, and in fact, may increase the risk of progressive visual loss in NAION patients. (aetna.com)
A structured evidence review (Dickersin and Manheimer, 2002) concluded that "[r]esults from the Ischemic Optic Neuropathy Decompression Trial indicate that optic nerve decompression surgery for nonarteritic ischemic optic neuropathy is not effective. (aetna.com)
A Cochrane review (Dickersin et al, 2012) concluded that results from the single trial indicate no evidence of a beneficial effect of optic nerve decompression surgery for NAION. (aetna.com)

Emergent operative technologies and surgical approaches have transformed today's otolaryngology-head and neck surgery, and the 3rd Edition of Operative Otolaryngology brings you up to date with all that's new in the field. (pickpdfs.com)
Basic surgical approaches to the skull base are outlined. (medscape.com)

Has been on the Scientific Committee for the North American Skull Base Society , is a member of the World Federation of Neurological Societies Skull Base Surgery committee, and has been a director or instructor in local/national/international Skull base courses. (ubc.ca)
INTRODUCTION: Intraoperative neurophysiology (ION) has been established over the past three decades as a valuable discipline to improve the safety of neurosurgical procedures with the main goal of reducing neurological morbidity. (bvsalud.org)
Our Epilepsy Surgery Program is part of a collaborative partnership between our neurosurgeons and neurological colleagues, working together to provide hope to adults and children with epilepsy. (lsuhs.edu)
The patients with such injuries require close medical supervision using multimodal neuromonitoring, which includes recording blood circulation parameters, monitoring neurological status, oxygen partial pressure and brain temperature. (bookinghealth.com)
Journal of neurological surgery. (uc.edu)
Using this cranial vault suspension and fusion technique results in lasting neurological improvement and construct stability. (thejns.org)

Intraventricular meningiomas probably arise from the meningothelial cells of the tela choroidea, where there is an arachnoidal invagination into the stromal base of the choroid plexus. (medscape.com)

Glossopharyngeal electromyography (EMG) monitoring electrodes are placed. (neupsykey.com)
Vascular compression of the nerve root exit zone (Figure 1) is characteristic of Trigeminal Neuralgia (TN), Hemifacial Spasm (HFS) and Glossopharyngeal Neuralgia (GPN) [1,2]. (heraldopenaccess.us)
GPN manifests as sharp, stabbing pulses of pain in the auricular and pharyngeal regions caused by neurovascular compression at the root exit zone of the glossopharyngeal nerve [1]. (heraldopenaccess.us)

With these cost-effective additions to the product line, surgeons have more reliable options using their stocked ET tubes to monitor the integrity of the laryngeal and vagus nerves and preserve the nerve function for patients. (neurosign.com)

Intra-operative monitoring of your nerve function and the use of real-time image guidance may be used to help achieve the safest resection possible. (welldonesite.com)
Middle Cranial Fossa Approach to Vestibular Schwannoma Resection in the Older Patient Population. (uc.edu)
Diffusion weighted MRI can be processed using diffusion tensor imaging based tractography to map out white matter tracts in the vicinity of the resection cavity ( 8 ). (frontiersin.org)

Certain stereotactic radiosurgery procedures may require the use of a reference frame placed on your skull, but many do not. (welldonesite.com)

Intraoperative seizure is the most prevalent and serious complication of awake craniotomy in functional areas, which may not only trigger complications of the surgical procedure or even the failure of awake craniotomy but also may result in adverse consequences to patients. (bvsalud.org)
Smooth muscle contraction of the urinary bladder and/ or the rectum in response to direct stimulation of innervating functional nerves correlated with a change in tissue impedance compared with the pre-contraction state. (bvsalud.org)
The Golby Lab is funded by the Brain Science Foundation, The Klarman Family Foundation, CIMIT Harvard Catalyst, and the National Institutes of Health, allowing her to assemble a team of extraordinary scientists from different backgrounds, working collaboratively to advance the field of image-guided surgery and functional brain imaging. (dana-farber.org)

The influencing factors of intraoperative seizures are unclear, and only the possible influencing factors can be acquired from the examination and summary of existing cases to offer guidance for the seizure prevention of intraoperative epilepsy. (bvsalud.org)

The use of IOM is valuable in precluding many potential complications during spinal surgeries. (princetonneurologicalsurgery.com)
We aimed to determine the frequency of neurotologic complications following this surgery. (heraldopenaccess.us)
Neurotologic complications are thought to be secondary to: stretching of CN VII and VIII during cerebellar retraction, direct trauma to CN VII or VIII, excessive manipulation of vasculature (especially the labyrinthine artery and anteroinferior cerebellar artery) or neocompression of nerves with the spacer placement [14,15]. (heraldopenaccess.us)

The anatomic relationship of the VIIth and VIIIth nerves in the IAC and the cerebellopontine angle region are important anatomic areas related to skull base surgery and neuro-otologists. (medscape.com)

[9] During the Middle Ages in Al-Andalus from 936 to 1013 AD, Al-Zahrawi performed surgical treatments of head injuries, skull fractures, spinal injuries, hydrocephalus , subdural effusions and headache. (wikipedia.org)

You can easily download Operative Otolaryngology head and Neck Surgery 2 Volume Set 3rd Edition PDF free by clicking the link given below. (pickpdfs.com)
Download instantly Cummings Otolaryngology - Head and Neck Surgery 3 Volume Set 7th Edition by Paul W. Flint, Bruce H. Haughey, Valerie J. Lund, K. Thomas Robbins, J. Regan Thomas. (booksca.ca)

For example, during any surgery on the thoracic or cervical spinal column, there is some risk to the spinal cord. (wikipedia.org)
Following exposure of the cranial and cervical portions of CN XI, lidocaine was applied to the course of the exposed nerve. (duke.edu)

The clonus test involved the surgeon stretching the patient's ankle during the surgery while the patient was still under anesthesia. (princetonneurologicalsurgery.com)

The sphenoid sinus (SS), a highly variable anatomic structure, is located in the center of the cranial base. (surgicalneurologyint.com)

This article discusses the aforementioned technological advances, and their multimodal use to optimize safe pediatric neuro-oncology surgery. (frontiersin.org)

For a given surgery, the set of modalities used depends in part on which neural structures are at risk. (wikipedia.org)
The osteotomy line can be planned and applied more delicately, preventing damage to the surrounding anatomical structures by referring to CT images and the location of the zygomatic nerves. (biomedcentral.com)

Long a pioneer in the intraoperative nerve monitoring field, Neurosign ® recently expanded its line of laryngeal electrodes with new single and dual channel surface electrodes. (neurosign.com)
All the laryngeal surface electrodes include a DIN 42802 universal connector for use with various multi-channel nerve monitors. (neurosign.com)

TN is a chronic pain syndrome characterized by episodes of paroxysmal, lancinating pain accompanied by an electric shock sensation that affects one or more distributions of the fifth cranial nerve. (heraldopenaccess.us)
Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. (e-jyms.org)

Patients benefit from neuromonitoring during certain surgical procedures, namely any surgery where there is risk to the nervous system. (wikipedia.org)

It consists of three nerves that link the eardrum to the brain, including the cochlear nerve (carries hearing information) and left and right nerves (carry balance signals from the inner ear to the brain). (facialparalysisinstitute.com)
Applications include improved cochlear implant development, inner ear regenerative techniques, inner ear surgery, and auditory physiology. (stanford.edu)
The peripheral segments of the cochlear and vestibular nerves join at the lateral part of the internal auditory canal (IAC) to form the vestibulocochlear nerve. (medscape.com)
The vestibular and cochlear (acoustic) ganglia neuroblasts are derived almost exclusively from the otocyst epithelium, in contrast to other cranial sensory ganglia in which both ganglionic and neural crest placodes make extensive contributions to the neuroblast populations. (medscape.com)
The fibers of the cochlear nerve originate from an aggregation of nerve cell bodies in the spiral ganglion, located in the modiolus of the cochlea. (medscape.com)
The longer central fibers, also called the primary auditory fibers, form the cochlear nerve, and the shorter, peripheral fibers extend to the bases of the inner and outer hair cells. (medscape.com)
The longer central processes of the bipolar cochlear neurons unite to form the cochlear nerve trunk. (medscape.com)
The division of cranial nerve (CN) VIII into the cochlear and vestibular branches may occur in the medial segment of the IAC or in the subarachnoid space. (medscape.com)

Cerebrospinal Fluid Leak Rate after Vestibular Schwannoma Surgery via Middle Cranial Fossa Approach. (uc.edu)

Multispecialty system for removing soft or hard tissue and bone during ENT, spinal, and cranial surgeries. (medtronic.com)
Once the surgeon is notified in real time by the device of imminent damage or the very beginnings of damage to nerve tissue, correction can take place to avoid loss of function. (princetonneurologicalsurgery.com)
Surgery often occurs within 72 hours of angioembolization to maximize benefits, while simultaneously occurring at increased risk of tissue necrosis, migration into collateral channels, and injury to the vasa nervorum in certain pedicles. (bmj.com)

Thirty patients (16 male, 14 female) involved in a prospective clinical investigation (German Clinical Trials Register DRKS00017437, date of first registration 31/03/2020) underwent nerve-sparing rectal surgery using a new approach to intraoperative pelvic neuromonitoring based on direct nerve stimulation and impedance measurement on target organs. (bvsalud.org)

Microsurgical robotics -- Developing scalable microsurgical instrumentation and robotic techniques for use in head and neck surgery. (stanford.edu)

A total of 88 patients underwent for TN underwent surgery at our hospital. (e-jyms.org)
Eighty-eight patients underwent 89 surgeries because one patient underwent reoperation. (e-jyms.org)

To reduce these risks for the patient, surgeons today employ intraoperative monitoring. (princetonneurologicalsurgery.com)
Intraoperative monitoring (IOM) of the nerves allows surgeons to oversee and keep tabs on the functioning of the nerves throughout a surgical procedure. (princetonneurologicalsurgery.com)
The team of skilled heart surgeons at The University of Kansas Health System in Kansas City offers the latest types of artificial heart valves for replacement surgery. (kansashealthsystem.com)

however, it is well-known that vascular compression at the root entry zone (REZ) of the trigeminal nerve is one of the major causes of TN [ 3 ]. (e-jyms.org)

The aim of this study was to examine the accuracy and feasibility of using the SpotOn sensor in lower extremity orthopedic surgery in elderly patients aged over 80 years by comparing a SpotOn sensor with 2 other reliable minimally invasive methods: a tympanic membrane thermometer and a bladder thermometer. (bvsalud.org)
The department's neurosurgeons also use minimally invasive surgery to treat spinal stenosis. (bookinghealth.com)

A year was then spent as a Clinical Fellow in Skull Base and Vascular Microneurosurgery under the guidance of Dr. Laligam Sekhar in Washington DC/Virginia. (ubc.ca)
The objective of this study was to transfer a new approach to intraoperative pelvic neuromonitoring based on bioimpedance measurement to a clinical setting. (bvsalud.org)
Includes all-new videos (more than 150 videos in all) showing step-by-step techniques and procedures such as management of tracheal stenosis and transoral and robotic tonsil surgery for cancers of the base of tongue and pharynx, plus new full-color clinical photographs and line drawings throughout the text. (pickpdfs.com)
Revisora habitual en el Journal of Clinical Monitoring and Computing. (neurologicsbcn.com)
Spinal surgery requires impeccable precision, and therefore the department's doctors widely use advanced three-dimensional navigation systems and robotic equipment in their clinical practice, which serve as a positioning tool and, in combination with the professionalism of the department's doctors, guarantee an optimal result. (bookinghealth.com)
this is a paid training program in a hospital or clinical setting covering a range of medical specialties including surgery. (wikipedia.org)

Diamox, Lasix, corticosteroids), and disc swelling with visual field loss progresses, direct fenestration of the optic nerve sheaths via medial or lateral orbitotomy has been shown to be an effective and relatively simple procedure for relief of papilledema. (aetna.com)
It has previously been reported that poor pneumatization of the lateral recess of the SS (LRSS) increases the difficulty level of the surgery and the risk of neural and vascular injury. (surgicalneurologyint.com)

CONCLUSION: Direct application of lidocaine to CN XI temporarily silenced neuromuscular activity and prevented unwanted trapezius contraction during skull base microsurgery. (duke.edu)

Since the 1970s, SSEP (somatosensory evoked potentials) have been used to monitor spinal cord function by stimulating a nerve distal to the surgery, and recording from the cerebral cortex or other locations rostral to the surgery. (wikipedia.org)
the motor cortex is stimulated transcranially, and recordings made from muscles in the limbs, or from spinal cord caudal to the surgery. (wikipedia.org)
This allows direct monitoring of motor tracts in the spinal cord. (wikipedia.org)
Although rare, some of the risks of these procedures may include injury to the spinal cord, damage to nerves and paralysis. (princetonneurologicalsurgery.com)
Based on studies in birds, the telencephalic leptomeninges arise from the neural crest (neuroectoderm) and the leptomeninges of the posterior brain and the spinal cord arises from the mesoderm. (medscape.com)
Spinal cord is a bundle of nerves that carries messages between the brain and the rest of the body. (neurosurgerynow.com)

and for early detection of intraoperative neural injury, allowing for immediate corrective measures. (wikipedia.org)
In contrast, all the supporting and Schwann cells are derived from neural crest cells, possibly from the VIIth nerve ganglion to which the vestibulocochlear ganglion is initially attached. (medscape.com)

Cranial vault suspension for basilar invagination in patients with open cranial sutures: technique and long-term follow-up. (thejns.org)
Hajdu-Cheney syndrome (HCS) is an extremely rare genetic disorder characterized by severe osteoporosis, scoliosis, and persistent open cranial sutures (POCSs). (thejns.org)

CT scan with axial bone windows and coronal plane reconstruction that demonstrates a fibrous osteoma that involves the right orbit and the floor of the anterior cranial fossa. (medscape.com)
This flap is most commonly used for glossectomy defects, orbital/maxillary defects, and (as a muscle-only flap) skull base reconstruction. (medscape.com)
As a muscle-only flap, it has become indispensable for reconstruction following skull base surgery. (medscape.com)

The pathologies involving the cavernous sinus and/or superior orbital fissure often threaten cranial nerves III, IV, & VI. (entokey.com)

Anatomy32

Diseases33

Analytical, Diagnostic and Therapeutic Techniques and Equipment17

Phenomena and Processes3

Information Science2

Health Care5

Tumors27

Eighth crani5

Acoustic neuroma2

Tumor12

Endoscopic11

Postoperative7

Posterior fossa3

Neurophysiological3

Motor evoked pot3

Neurosurgery10

Neurovascular structures2

Preoperative4

Intracranial5

Disorders5

Peripheral nerves1

Neoplasms2

Spine3

Multiple cranial1

Carotid2

Lesions7

Brainstem3

Outcomes7

Facial25

Neurophysiologic1

Decompression6

Approaches2

Neurological6

Meningiomas1

Glossopharyngeal3

Vagus1

Resection3

Stereotactic1

Functional3

Epilepsy1

Complications3

Cerebellopontine angle1

Hydrocephalus1

Otolaryngology2

Cervical2

Anesthesia1

Anatomic1

Pediatric1

Structures2

Laryngeal2

Fifth crani2

Surgical procedures1

Cochlear8

Cerebrospinal fluid1

Tissue3

20201

Neck1

Underwent2

Surgeons3

Trigeminal nerve1

Minimally-invasive2

Clinical6

Lateral2

Microsurgery1

Spinal cord6

Neural2

Sutures2

Reconstruction3

Sinus1